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Biomedical subjects

A O Omigbodun

Publications and source records attributed to A O Omigbodun.

At least 19 recordsLinked to original sources
PubMed2006

Factors influencing gestational age at antenatal booking at the University College Hospital, Ibadan, Nigeria.

In order to achieve the aim of improved outcome of pregnancy for mother and fetus, early booking (first antenatal visit), prior to 14 weeks' gestation is usually recommended. A survey of information on personal data, index pregnancy, reasons for booking at a particular gestational age, past obstetric history and medical history of 205 pregnant women attending the antenatal booking clinic at the University College Hospital, Ibadan, Nigeria was carried out using a structured questionnaire. The mean gestational age at booking was 21.82 (+/-7.0) weeks. Only 29 patients (14.1%) booked before 14 weeks. The reasons given for early booking among them were the perceived benefits of such practice (41.4%), physician's recommendation (34.5%) and occurrence of complication(s) in previous pregnancy (24.1%). Illness in the index pregnancy and nulliparity were the only factors found to significantly favour early booking. The need to educate women of the reproductive age group, who are potential mothers, on the benefits of early booking was recommended.

Adolescent↗
PubMed2006

Acceptability of caesarean delivery to antenatal patients in a tertiary health facility in south-west Nigeria.

Today, caesarean section is one of the most commonly performed surgical procedures the world over. Despite the well-documented record of safety, the strong aversion of women in sub-Saharan Africa to the procedure, especially in the presence of life-threatening indications, is of great concern to many obstetricians. This cross-sectional study, aimed at assessing the knowledge of the patients about caesarean section and its acceptability as mode of delivery, was conducted among antenatal patients at a University Teaching Hospital in south-west Nigeria. A pre-tested structured questionnaire was used. Among the 201 patients surveyed, a high level of acceptability of caesarean section (85%) was found. However, 96.5% of those who would accept would give consent only after seeking the opinion of other people, especially their husbands. Previous major surgery and caesarean section were found to favour its acceptability, while age, tribe, marital status and the woman or her husband's educational status did not have any influence. With proper health education, especially during antenatal care, many more women would find caesarean section acceptable.

Adult↗
PubMed2005

Pre-induction cervical ripening: transcervical foley catheter versus intravaginal misoprostol.

The object of this study was to compare the effectiveness of the intravaginal Misoprostol and transcervical Foley catheters as pre-induction cervical ripening agents, to estimate the proportion of patients achieving vaginal delivery and to compare the complications of labour and foetal outcome between the two groups. The study was a prospective, randomised study of pregnant women, with singleton pregnancies who presented for antenatal care and delivery at the University College Hospital (UCH), Ibadan, Nigeria. Ninety-nine patients were invited to participate and ninety-six (96) agreed. No patient withdrew from the study. The patients were assigned by means of computer-generated random numbers to receive transcervical Foley catheters (Size 16F, with 30 ml balloon capacity) or 50 microg intravaginal Misoprostol (Cytotec tablet, Searle & Co., Chicago). Fifty (50) patients received intravaginal Misoprostol and Forty-six (46) received Transcervical Foley catheters. The proportions of nulliparous, primiparous and multiparous patients were 52, 20 and 28% in the misoprostol group and 43.5, 26.1 and 30.4%, respectively, in the Foley catheter group. The time to achieve a favourable cervical status was significantly shorter in the Misoprostol group, with 98.0% of the subjects attaining Bishop score > or = 6 within 6-12 hours of insertion of the study agent, in contrast to 69.0% of the subjects in the Foley catheters group (P<0.001). Thirteen (26.6%) and three (6.5%) patients in the Misoprostol and Foley catheters groups, respectively, went into labour while undergoing cervical ripening and all had uneventful vaginal deliveries (P<0.05). The induction-delivery interval did not differ significantly between the groups. The incidence of caesarean delivery was 6.0% in the Misoprostol group compared with 2.2% in the Foley catheter group (P=0.62). Instrumental vaginal delivery rates were similar in both groups. Overall, the mode of delivery did not differ significantly between the groups. The number of neonates with 1-minute Apgar score <7 did not differ significantly in both groups and no neonate had 5-minute Apgar score <7. Meconium stained liquor was noticed in 5 (Misoprostol) vs 2 (Foley catheters) patients in labour. None of the neonates had any features suggestive of meconium aspiration. Labour complications were mainly precipitate labour {2 (Misoprostol) vs 1 (Foley catheters) } and 1 patient with transient tachysystole (> or =6 contractions in 10 minutes for two consecutive 10-minute periods) in the Misoprostol group. Hyperstimulation was not noticed in any of the patients in either arm of the study groups. Intravaginal Misoprostol is as effective a pre-induction cervical ripening agent as transcervical Foley catheters, with added advantages of shorter duration of cervical ripening, reduced oxytocin requirement for induction of labour and greater acceptability to patients. The incidence of caesarean sections, other labour complications and the foetal outcome were similar with both methods.

Administration, Intravaginal↗
PubMed2005

Mobilization for cervical cancer screening: lessons from a poor-urban Yoruba community in Nigeria.

Cervical cancer is a major public health problem worldwide and it remains one of the commonest malignancies in Nigeria. Screening remains the most effective tool for the detection of pre-invasive stages of cervical cancer, giving the opportunity for prompt and effective treatment before the emergence of invasive disease. In Nigeria, as in most developing countries, the concept of screening for cancer and its pre-emptive treatment is underdeveloped. The fact that the facilities and logistics for cervical cancer screening are generally located in the hospital setting, a place where one goes when ill, according to local beliefs, makes acceptance more difficult. That Nigeria urgently needs to set up or develop cervical screening programmes that will reach women outside the hospital setting in a culturally acceptable milieu is not in doubt. A community cervical screening survey for the prevalence of cervical intraepithelial neoplasia and HPV infection was initiated in Idikan, a poor-urban inner core area of Ibadan. The challenges and experiences encountered in the execution of the project which could serve as useful knowledge to those undertaking similar exercises, requiring mass mobilization for cancer screening of an uninformed group, are highlighted. Our experience in the course of this study is important as it brought out the probable influences of community dynamics and social organization in illness decisions and prescriptions for health operative in this particular population group. Cervical cancer screening programmes should therefore make provisions to accommodate the occasional outcomes as we had encountered. In addition, screening programmes in developing societies would require sensitive designs that should address the cultural attitudes, personal conflicts, expectations of treatment and overall context of preventive care.

Adolescent↗
PubMed2005

Abdominal pregnancy at the University College Hospital, Ibadan: a ten-year review.

Fourteen cases of abdominal pregnancy managed at the University College Hospital, Ibadan, Nigeria, over a ten-year period (January 1994 to December 2003) were reviewed. The incidence ratio of abdominal pregnancy was one in 654 deliveries. It accounted for 4.3% of ectopic pregnancies. Age range was 20 to 43 years; 63.4% of the patients were unemployed and 50% were nullipara. Pre-operative diagnosis was possible only in half of the cases. Only two patients with advanced pregnancies and live fetuses (14.3%) were allowed to have conservative management while the others had immediate laparotomy. Live birth rate was 7.1%, but overall fetal survival rate was 0%. Fetal malformations were common, with talipes equinovarus and jaw abnormalities occurring in 49.2% and 14.3% respectively. Twelve patients (85.7%) who had complete removal of the placenta, though lost more blood, had better outcome than those with placenta left in-situ. The case fatality rate was 7.1%.

Adult↗
PubMed2005

Total ovulating period: any contribution to ovarian carcinogenesis?

The etiology of ovarian cancer has many postulates including that of incessant ovulation. Women of high parity especially those that breastfeed in addition are supposed to be protected. Ovarian cancer patients in the developing world are of higher parity than their Caucasian counterparts. Our study compared the length of reproductive career (LRC), the physiological ovulation free period (PFP) and the total ovulating period (TOP) amongst histologically proven ovarian cancer patients and age - matched controls. This is a questionnaire survey of 21 ovarian cancer patients managed by us between 1st December 1998 and 31st July 2002 and 42 gynaecological patients not known to have ovarian cancer. The mean age among the patients was 45.7+16.9 years while among the controls it was 45.4 +/- 16.1 years. The mean parity of the patients was 3.6 +/- 2.2 compared to 3.4 +/- 2.9 in the controls. The patients had a mean LRC of 23.8 +/- 11.2 years while in the controls it was 25.7+10.8 years. The mean PFP of the patients was 7.4 +/- 5.6 years and for the controls 7.1 +/- 6.5 years. The patients had a mean TOP of 15.8 +/- 8.8 years while this was 18.6 +/- 8.1 years for the controls. None of these differences was statistically significant. Our study revealed no statistically significant differences in the total ovulating periods between ovarian cancer patients and age-matched controls. Further studies will be necessary.

Adult↗
PubMed2005

Comparison of changes in pre-induction cervical factors' scores following ripening with transcervical foley catheter and intravaginal misoprostol.

The study compares the changes in the cervical factors in pre-induction cervical ripening with both transcervical Foley catheter and Intravaginal Misoprostol. This was a randomised prospective study of pregnant women, with singleton gestations who presented for antenatal care and delivery at a tertiary health institution in the South-western Nigeria between 1st March 2003 and 31st March 2004. One hundred and two (102) patients received 50microg intravaginal Misoprostol and Ninety-six (96) received size 16F Transcervical Foley catheters. Both groups were similar at the baseline. Misoprostol group showed greater improvement in the final cervical length score, with 38.4% and 58.6% scoring 2 and 3 respectively, in contrast with the Foley catheter group where 77.7% had final score of 1, with only 16% scoring 2 and none scored 3 (P = 0.00). Ninety-one percent of the patients in the misoprostol group achieved the maximum cervical consistency score of 2, contrasting with the 31.9% in the Foley Catheter group (P = 0.00). 64.9% of the patients in the Foley catheter group did not achieve appreciable change in cervical consistency. Our findings indicate that intravaginal misoprostol was more effective in improving the scores of cervical length and consistency, while transcervical Foley catheter was better at improving the cervical os dilatation score at pre-induction cervical ripening. The clinical implication is that, patients for pre-induction cervical ripening can be selected for either of these ripening agents based on which cervical factors require improvement in scores

Abortifacient Agents, Nonsteroidal↗
PubMed2003

Influence of gender on undergraduate performance in psychiatry at Ibadan, Nigeria.

OBJECTIVE: This study examined the influence of gender on undergraduate performance in psychiatry among final year medical students at the University College Hospital, Ibadan, Nigeria. METHODS: Results in all parts of the examination in psychiatry for the 2001 graduating class were obtained. In addition, performance scores were obtained for entrance examinations to medical school, preclinical subjects (anatomy, physiology and biochemistry) and clinical subjects (paediatrics, obstetrics and gynaecology, internal medicine and surgery). The mean marks according to gender, with 95% intervals, were calculated and tested for significance. RESULTS: A total of 234 students (160 men and 74 women) took the examinations in psychiatry. Women performed better than men in both the multiple choice questions (MCQ) examination (P = 0.0044) and the clinical assessment (P= 0.0000063). The women were significantly younger than the men (P = 0-0000007) and performance in both parts of the examination decreased with increasing age. There were no differences between the genders in entrance examination scores or preclinical scores but there were significant differences between the genders in performance in clinical subjects such as paediatrics, obstetrics and gynaecology and internal medicine. CONCLUSION: Women performed better than men in all parts of the psychiatry examination, with the difference being more marked in the clinical aspect. A superior performance on the part of women was noted in all clinical subjects. However, where an examination did not involve verbal interaction, there was no difference in performance between the genders. A direct correlation between increasing age and decreasing performance in examinations was also seen.

Adult↗
PubMed2003

Knowledge, attitude and practices related to prevention of cancer of the cervix among female health workers in Ibadan.

Cervical cancer, although largely preventable, remains a leading cause of cancer death in the developing world. The study was aimed at finding out the level of awareness of female health workers about cervical cancer and the level of utilisation of preventive measures. A 20-item questionnaire containing items on characteristics and knowledge of respondents on aetiology and prevention of cervical cancer was administered to a total of 205 female doctors, nurses and hospital maids in three hospitals within Ibadan metropolis. Knowledge about the condition was high among doctors, surprisingly inadequate among nurses and predictably poor among hospital maids (due possibly to lack of formal paramedical training). However, 93.2% of respondents have never had Pap smears performed. The poor utilisation of the test was independent of respondent's profession, marital status or hospital. Therefore, there is a need to intensify compaign towards prevention of cervical cancer even among health workers.

Attitude of Health Personnel↗
PubMed2003

Impact of maximal cervical dilatation at primary caesarean delivery on mode of delivery in the following pregnancy.

The maximum cervical dilatation achieved by parturients who went through labour prior to their primary caesarean births were related to the mode of delivery in the subsequent birth to ascertain if there is a link between the two. The success rates of vaginal births after primary Caesarean sections (VBAC) for arrest and non-arrest disorders were also compared using information derived from the birth records of the hospital. The success rate for VBAC was significantly high in subjects whose primary caesarean sections were for non-arrest disorders compared to those who had arrest disorders (73.3% versus 55.6%; x2 = 5.25, p = 0.02). The maximum cervical dilatation reached before primary caesarean section did not significantly affect the success rate of VBAC in the subsequent delivery (x2 [trend] = 0.78, p = 0.68). Patients who had primary caesarean section for arrest disorder require full evaluation before being allowed to attempt vaginal birth in a subsequent pregnancy but the maximum cervical dilatation reached before primary caesarean section need not be factored into a decision for VBAC.

Adult↗
PubMed2003

Does screening for cervical intra-epithelial neoplasm in developing countries prevent invasive cervical cancer?

In a bid to evaluate the practical relevance of screening for cervical intraepithelial neoplasia (CIN) in reducing the incidence of invasive cancer in Nigeria, we performed a comparative study of CIN and invasive carcinoma in Ibadan, Nigeria over a period of 8 and 16 years respectively. 4.5% of patients with invasive cervical cancer were under the age of 30 years. It peaked at 28% in the age group 41-50 years. In comparison, <3% of patients with CIN were below 20 years of age while it had the highest incidence of 37%, 34% and 36% respectively in age 40 years and below. The mean age for CIN was 39.6 +/- 9.6 (SD) years compared to 51.3 +/- 11.1 (SD) years for invasive cervical cancer (p < 0.01). There was a 10 year interval between the onset and peak age incidence of invasive cancer and CIN respectively, even though there was an overlap of cases from the third decade. We therefore suggest a combined approach of public education to encourage early presentation and provision of health service outlets for cervical cancer screening in Nigeria to reduce the burden of cervical cancer.

Adult↗
PubMed2001

Experience with computed tomography (CT) pelvimetry in Ibadan, Nigeria: a preliminary report.

Computed tomography (CT) pelvimetry has largely replaced conventional radiography in the antenatal assessment of pelvic dimensions, but its usefulness in the Nigerian setting is yet to be assessed. This study was undertaken to ascertain if there is a relationship between antenatal CT pelvimetric measurements and the mode of delivery at the end of the pregnancy. A group of thirty-one patients who had antenatal pelvimetry were categorised into two groups depending on whether they achieved vaginal delivery or not and the pelvimetric and other obstetrrc characteristics of the two groups were compared. The only parameters that showed statistically significant differences between the groups were the higher maternal height and the lower head circumference in the neonates of women achieving vaginal delivery. The findings suggest that fetal parameters may be more predictive of mode of delivery than absolute pelvic measurements.

Birth Weight↗